I am nowhere near surg/ob/gyn adjacent, and I think surgeons are crazy people who meet criteria for addiction to their field. They remind me of the workhorses from Animal Farm, Orwell's book. They are the workhorses of medicine, as Cesar Milan the Dog Whisperer might say, the "high energy dogs." I think most are a lot of fun to grab a beer with ironically, but I don't like working with them. Diametrically opposed personalities you could say.
Anyway, despite all that, I'm the first now to defend everyone in medicine getting a decent amount of surgical experience. In AND out of the OR. For the vast number of MD grads and where they end up, there's a lot of things you'll need to know.
Morning rounds were much more educational than I thought. The dressing changes - that's when I probably learned the most about wound care and healing, learning to distinguish a "good" looking stoma takedown (none of them look good is my point, that's why you need this exposure) that's healing well, post-op dehissence, etc. (**** did I spell that right?). How much erythema is normal and how much is concern for infection? People skip their post op follow up all the time, and while it's not supposed to be your job, it's good to have a feel when you can take those staples out.
Generalists, PCPs, hospitalists, and ED docs, etc will all see patients in various stages of healing (or not healing, post op). We're not experts but we need to be able to recognize post op complications as much as the next doc.
Lastly, us other docs are usually the ones referring people for surgery, we're usually the first "gatekeepers" on the way to the OR if you will. We need to recognize surgical problems and refer. Also, we need a healthy respect for surgery and what that puts a patient through. People seem to think that surgery goes down as cleanly and precisely as taking apart and putting back together Lego blocks - when the truth is it has more in common with the last time you skinned and pieced out a whole chicken than it does Lincoln Logs. Anyone that has gone under the knife will not emerge the "same" even if the goal was just to correct pathology. Things don't come back together all that cleanly. We need to see the surgical chaos and respect it as a last resort not an easy fix.
Those 3 hours holding the retractor is when you will be present to see an artery get nicked and dealt with. That's when you'll see an unexpected anatomical variant lead to a nicked nerve and some post op symptoms. That's when you'll get a chance to see how a hemorrhage is controlled. You'll see how easy it is for things to go wrong and appreciate the difficulty. You'll understand the uncertainty that surgeons deal with.
I've come around to the view that this is valuable knowledge for all MDs to be running around with which is why I support really putting on a surgeon's cap and walking a mile in those shoes for a few weeks. I've cleared patients for surgery, risk stratified, referred, called urgent surgical consults, and managed patients medically pre and post op, and relied on surg recs to manage patients. I need to understand their "language" and thought process and notes. It's all ****ing relevant.
I think we need to do a better job of explaining why surgery rotations matter to non-surg bent students. Point out what they can be getting from those hours in the OR watching. If nothing else it should teach you some hefty respect for surgery.
Anyway, what was described does not sound like a good approximation of walking a mile in a surgeon's shoes. Studying for the shelf isn't enough IMHO to get what you should be getting out of the rotation.
TLDR:
need to learn respect for the surgical process and understand where you fit into it no matter what field you go into
take it from someone who hates all things surgical, those rotations are relevant to all MDs in one way or another IMO
read the above for some ideas on what you should be getting out of the rotation as a non-surg bent person[/USER]